The structure and vascularization of the biceps brachii long head tendon

In the present study we examined the structure and the blood supply of the long biceps tendon as well as the surface of the intertubercular sulcus, using tissue samples from children and adults. The applied methods were light and electron microscopy, immunohistochemistry, and arterial injection techniques. The tendon represents a sliding tendon with the intertubercular sulcus and humeral head as hypomochlion. The parts facing the humerus show some ultrastructural features of fibrous cartilage, the ovoid chondrocyte-like cells of the tendon lying within felt-like matrix. In the opposite part adjacent to the capsule, the tendon resembles a traction tendon. The intertubercular sulcus is covered by fibrous cartilage. The tendon is supplied with arteries from three different sources. The density of intratendinous vessels in the traction zone is comparable to that of other tendons, while in the sliding zone it is markably decreased. The immediate vicinity of the sliding surface is avascular. Our findings show that the long biceps tendon is structurally adapted to both its functions as sliding and traction tendon. The blood supply seems to be related to the metabolic requirements of the different parts of the tendon.